Effects of exposure to plus-size fashion models on weight-related attitudes in bulimia nervosa: Findings from an exploratory study.

BACKGROUND AND OBJECTIVES: Eating disorders are often linked to the internalization of the thin-ideal and weight stigma. The present exploratory study investigates the effects of plus-sized fashion media on weight-related attitudes in bulimia nervosa (BN). METHODS: Women with BN (n=27) and without an eating disorder (n=28) were exposed to 17 pictures of plus-size fashion models. Participants rated the attractiveness of the models. Before and after the exposure task, participants completed questionnaires on their attitudes towards people with higher weight as well as thin-ideal media. RESULTS: The BN group rated the bodies of the plus-size fashion models as less attractive than controls, whereas no group differences were found in attractiveness ratings for the models' faces or full images. In both groups, negative attitudes about people with higher weight significantly decreased after viewing plus-size model pictures. Attitudes toward thin-ideal media remained unchanged, with scores higher for BN than controls. LIMITATIONS: This exploratory study has several limitations, such as the lack of a control condition, small sample size, and reliance on only self-report data. CONCLUSIONS: These exploratory results imply that the positive effects of plus-sized model images on reducing negative assumptions about people with high weight may not be limited to healthy individuals but also seem to extend to women with BN. Further controlled studies with larger samples and long-term assessments are needed to confirm these findings.

Gigapixel imaging with a novel multi-camera array microscope.

The dynamics of living organisms are organized across many spatial scales. However, current cost-effective imaging systems can measure only a subset of these scales at once. We have created a scalable multi-camera array microscope (MCAM) that enables comprehensive high-resolution recording from multiple spatial scales simultaneously, ranging from structures that approach the cellular scale to large-group behavioral dynamics. By collecting data from up to 96 cameras, we computationally generate gigapixel-scale images and movies with a field of view over hundreds of square centimeters at an optical resolution of 18 µm. This allows us to observe the behavior and fine anatomical features of numerous freely moving model organisms on multiple spatial scales, including larval zebrafish, fruit flies, nematodes, carpenter ants, and slime mold. Further, the MCAM architecture allows stereoscopic tracking of the z-position of organisms using the overlapping field of view from adjacent cameras. Overall, by removing the bottlenecks imposed by single-camera image acquisition systems, the MCAM provides a powerful platform for investigating detailed biological features and behavioral processes of small model organisms across a wide range of spatial scales.

Efficacy and mechanisms of change in exposure-based and cognitive stand-alone body image interventions in women with overweight and obesity.

OBJECTIVE: Body dissatisfaction is highly prevalent in overweight and obesity, while evidence for the efficacy of body image interventions is still scarce. This interventional pilot study investigates the efficacy and mechanisms of change of two stand-alone body image interventions in women with overweight and obesity. METHODS: Women with overweight and obesity (n = 76) were randomly assigned to five weekly sessions of either a mirror exposure (ME) or a cognitive restructuring intervention (CR) or to a wait-list control group (WCG). Primary outcome measures were self-reported body dissatisfaction and interview-based shape concerns; depression, self-esteem and emotional eating served as secondary outcome measures. Experimental paradigms were used prior to and after the interventions to analyze possible mechanisms of change: (a) Implicit Associations Tests to assess weight-related attitudes (b) eye-tracking experiments to assess visual processing of body pictures and (c) a thought-sampling procedure to assess body-related cognitions and arousal. RESULTS: According to intent-to-treat analyses using linear mixed-models, both interventions lead to significant improvements in body image, while there were no changes in the WCG. Different mechanisms of change were identified. CONCLUSIONS: Both types of interventions might be effective in the reduction of self-reported body dissatisfaction and interview-based shape concerns in overweight and obesity. However, as different mechanisms drive the effects, future research should clarify which individual might best benefit from which intervention.

Mirror exposure in binge-eating disorder: Changes in eating pathology and attentional biases.

OBJECTIVE: Body image disturbance is crucial in the psychopathology of binge-eating disorder (BED). According to cognitive models of eating disorders, biased attentional processes contribute to the development and maintenance of body image concerns. Mirror exposure constitutes an effective method to improve body image. The present study investigated if stand-alone mirror exposure reduces body image concerns, eating pathology as well as body-related attention processes in BED. METHOD: Women with BED were assigned to an intervention group (IG; four sessions of mirror exposure) or a waiting list control group (WL; 4 weeks waiting period). Prior to and after the intervention/waiting period, body image concerns, and attentional processes toward the self- and a control-body were measured using questionnaires and two eye-tracking tasks. All analyses were conducted on intent-to-treat (ITT) bases. RESULTS: Relative to the WL, the IG reported lower levels of shape concerns and reduced eating pathology after the intervention. Furthermore, while at baseline attention for the most unattractive body part was higher for the self-body (SB) relative to the control body (CB) in both IG and WL, no such difference was found after the intervention in the IG. By contrast, in the WL attention allocation between SB and CB remained unchanged. CONCLUSIONS: Evidence was found that stand-alone mirror exposure may contribute to improving shape concerns and the reduction of eating pathology in women with BED. Furthermore, mirror exposure impacts selective body-related attention even though generalizability of results is limited by small sample size, lack of statistical power, and expectancy effects due to comparison with WL. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Attentional processing of body images in women with overweight and obesity.

PURPOSE: Despite the claim to integrate body image interventions in obesity treatment, little is known about the mechanisms involved in maintaining body dissatisfaction in persons with overweight and obesity. Therefore, the present study sought to investigate attentional processing of body stimuli in women with overweight and obesity (OW). METHODS: Women with OW (n = 82) and normal weight controls (NW; n = 44) conducted two eye-tracking paradigms. In the first paradigm, fixation duration on the subjectively most beautiful and ugliest body part of one's own and a weight-matched control body were analyzed. In the second paradigm, picture pairs including the own and a control body or object were presented and initial fixation orientation was measured. Automatic and intentional processing of the body pictures was manipulated by either indicating on which side which stimuli would appear or not. RESULTS: Women with OW displayed a bias towards the ugliest as opposed to the most beautiful body part, whereas women with NW showed a balanced viewing pattern. Furthermore, both groups showed a preference for bodies relative to the object. However, only women with OW preferred their own relative to the control body during intentional processing. CONCLUSION: Taken together, results point towards a self-focused and deficit-oriented gaze pattern in women with overweight and obesity. Targeting these processes might help to improve obesity treatment outcomes. LEVEL OF EVIDENCE: Level I, experimental study.

Taking a closer look at body processing in binge eating disorder - Influence of BMI and eating pathology.

Individuals with binge eating disorder (BED) show preferred attention allocation towards their own (vs. another) body, and towards self-disliked (vs. self-liked) body parts. It remains unclear whether these gaze patterns are a consequence of underlying eating pathology or increased weight. In this study, women with BED (N = 73), overweight (N = 38) and healthy weight (N = 42) female control groups (CG) performed two eye-tracking paradigms using pictures of their own and a control-body. In task 1 (processing their own vs. a control-body), the BED group displayed a stronger preference for the own body during more automatic processing relative to the overweight CG, whereas the healthy weight CG showed a balanced attention distribution between both bodies. In task 2, all groups showed a bias towards the most unattractive relative to the most attractive part of their own body. This was strongest in the BED and overweight groups, but only the BED group showed a negative bias towards the control-body. Results indicate a stronger self-focused and deficit-oriented bias in the BED group but also some abnormalities in overweight individuals. Future studies should test whether these biases are modifiable, and whether their modification improves body image.

The efficacy of a transdiagnostic emotion regulation skills training in the treatment of binge-eating disorder-Results from a randomized controlled trial.

OBJECTIVES: Deficits in emotion regulation (ER) have been shown to be associated with binge-eating disorder (BED). To further clarify the causal nature of this association, we tested whether systematically enhancing ER skills would reduce symptoms of BED. METHODS: We randomly allocated N = 101 individuals meeting the criteria for BED to a transdiagnostic ER skills training or to a waitlist control condition (WLC). Primary outcome was the reduction in binges during the treatment-vs.-waiting period as assessed with the Eating Disorder Examination (EDE) interview. RESULTS: Mixed-model ANOVAs indicated that the average pre-to-post decrease in binges assessed with the EDE was significantly greater in the ER skills training condition than in the WLC (d = 0.66). These effects were stable over the 6-month follow-up period (d = 0.72). Remission rates at post/follow-up were 34.4/45.0% in the skills training and 7.5/20.0% in the WLC. Additionally, we found a greater reduction in general eating disorder psychopathology, of food consumption in a bogus taste test and of depression in the ER skills training condition. Moreover, the greater reduction in binge-eating episodes in the training condition was (partially) mediated by a greater increase in ER skills. CONCLUSIONS: The findings provide further support for the assumed importance of deficits in ER as a maintaining factor and, hence, as a target in the treatment of BED. As ER skills trainings have been shown to also reduce other kinds of psychopathology, they might be considered a promising transdiagnostic add-on component to disorder-specific interventions.

Influence of suppression and reappraisal on eating-related symptoms and ruminative thinking in anorexia nervosa and bulimia nervosa.

The goal of the present study was to investigate the influence of expressive suppression and cognitive reappraisal on eating-related symptomatology in anorexia nervosa (AN) and bulimia nervosa (BN). Secondly, on the background of theoretical models proposing a reciprocal relationship between suppression and rumination, we sought to understand whether inhibition of emotional expression also affects ruminative thinking in eating disorders. Women with AN (n = 39), BN (n = 37) and a control group (CG, n = 41) were randomly assigned to either engage in suppression or reappraisal during a sadness-eliciting film clip. Levels of drive to eat, anticipated loss of control over eating and ruminative thoughts were rated before and after the induction of emotion regulation. Induced expressive suppression led to a decrease of reported drive to eat in AN and an increase of anticipated loss of control over eating in BN. All groups responded to suppression with greater rumination, whereas no significant changes were found for reappraisal. Mediation analyses on trait questionnaires pointed to rumination as a partial mediator of the correlation between suppression and eating disorder pathology. Results are discussed in line with recent empirical research and current emotion regulation theories.

Body Exposure, its Forms of Delivery and Potentially Associated Working Mechanisms: How to Move the Field Forward.

Background: Body image disturbance (BID) is a hallmark feature of eating disorders (EDs) and has proven to be involved in their etiology and maintenance. Therefore, the targeting of BID in treatment is crucial, and has been incorporated in various treatment manuals. One of the most common techniques in the treatment of BID is body exposure (BE), the confrontation with one's own body. BE has been found to be effective in individuals with EDs or high body dissatisfaction. However, BE is applied in a multitude of ways, most of which are based on one or a combination of the hypothesized underlying working mechanisms, with no differential effectiveness known so far. Method: The aim of this paper is to selectively review the main hypothesized working mechanisms of BE and their translation into therapeutic approaches. Results and Conclusion: Specifically, we underline that studies are needed to pinpoint the proposed mechanisms and to develop an empirically informed theoretical model of BE. We provide a framework for future studies in order to identify working mechanisms and increase effectiveness of BE.

Whole-brain interactions underlying zebrafish behavior.

Detailed quantification of neural dynamics across the entire brain will be the key to genuinely understanding perception and behavior. With the recent developments in microscopy and biosensor engineering, the zebrafish has made a grand entrance in neuroscience as its small size and optical transparency enable imaging access to its entire brain at cellular and even subcellular resolution. However, until recently many neurobiological insights were largely correlational or provided little mechanistic insight into the brain-wide population dynamics generated by diverse types of neurons. Now with increasingly sophisticated behavioral, imaging, and causal intervention paradigms, zebrafish are revealing how entire vertebrate brains function. Here we review recent research that fulfills promises made by the early wave of technical advances. These studies reveal new features of brain-wide neural processing and the importance of integrative investigation and computational modelling. Moreover, we outline the future tools necessary for solving broader brain-scale circuit problems.

ERP and oscillatory differences in overweight/obese and normal-weight adolescents in response to food stimuli.

BACKGROUND: Findings are mixed regarding the association of electroencephalographic (EEG) attentional bias measures and body weight, with few studies measuring food craving or intake and no study reporting oscillatory measures. METHODS: EEG data were collected while 28 satiated adolescents (14 overweight/obese) viewed pictures of neutral, low-calorie food, and high-calorie food stimuli and rated their desire to eat, before having access to high-calorie snacks. RESULTS: Unlike normal-weight adolescents, overweight/obese participants showed similar P300 amplitudes for high- and low-calorie food, and strongest event-related alpha band desynchronization for low-calorie stimuli. P300 amplitudes and state craving for low-calorie food furthermore predicted snack intake in this group. CONCLUSIONS: The current research focus in overweight/obesity might need to be extended to include low-calorie food. While all participants showed an attentional bias for high-calorie food, it was the processing of low-calorie food which distinguished the two weight groups on measures of neural activity and which was associated with snack food intake in the overweight/obese group.

The Body Image Approach Test (BIAT): A Potential Measure of the Behavioral Components of Body Image Disturbance in Anorexia and Bulimia Nervosa?

A disturbed body image with fluctuating behavioral patterns of body related avoidance (BA) and body checking (BC) characterizes individuals with eating disorders (EDs) such as anorexia (AN) or bulimia nervosa (BN). So far, these behavioral body image components are mostly assessed via self-report instruments thereby neglecting their behavioral and partially automatic characteristics. Therefore, behavioral measures of BA and BC are needed. The present study investigates a behavioral assessment task for BA and BC in a sample of patients with diagnosed EDs and healthy controls. The sample consisted of 40 women diagnosed with either BN (N = 19) or AN (N = 21; ED sample) and 24 non-eating disordered, healthy female controls (HC). Within the Body Image Approach Task (BIAT) participants viewed photos of their own body (self-image) and a matched control body (other-image) by zooming the photos closer toward them (image became more focused) on the screen. The BIAT yields zoom-levels recorded separately for self- relative to other-images. Further measures were attractiveness ratings of these body images as well as questionnaire measures of BA, BC, and general ED symptomatology. Results showed that despite strong body dissatisfaction and clearly negative ratings of self- relative to other-images in both EDs, no group differences were found in approach to self-images on zoom-level as measured with the BIAT. Correlational analysis in each group indicated that zoom-level was positively related to BA scores in the HC group only. Yet, stepwise regression analyses revealed that attractiveness ratings explained most of the variance accounted by BA in predicting zoom-level. In sum, the BIAT seems suitable to assess BA and self-rated body attractiveness, but only in healthy individuals with subclinical levels on these constructs. It does not seem to capture the body image satisfaction or the behavioral components of body image disturbances in AN or BN or it conflates the opposed influences of BA and BC. Further experimentation is needed to adapt measures of behavioral body image components to the processes evoked in patients with ED during confrontation with body images.

Vocal arousal: a physiological correlate of body distress in women with overweight and obesity.

PURPOSE: Numerous studies highlight the relevance of body image in the development and maintenance of overweight and obesity mostly using self-reported data. Given the importance of physiological assessment methods, the present study aimed at investigating vocally encoded emotional arousal as a correlate of body distress in women with overweight and obesity. METHODS: Cognitions of women with overweight and obesity (OW; n = 22) as well as normal weight controls (NW; n = 22) were assessed by means of a thought-sampling procedure during a mirror exposure and a control condition. Fundamental frequency (f0) as a marker of vocally encoded emotional arousal as well as verbalized body-related cognitions were analyzed during this experimental task. RESULTS: A stronger increase in f0 between the control and the mirror exposure condition was found in OW compared to NW. Furthermore, there were significant positive correlations between vocally encoded emotional arousal and various measures of body image. CONCLUSION: The findings support the utility of vocally encoded emotional arousal as an objective physiological correlate of the evaluative dimension of body image in women with overweight and obesity. LEVEL OF EVIDENCE: Level I, experimental study.

Eye-tracking study on the effects of happiness and sadness on body dissatisfaction and selective visual attention during mirror exposure in bulimia nervosa.

OBJECTIVE: Abundant research points to the central role of body image disturbances in the occurrence of eating disorders (ED). While emotional arousal has been identified as a trigger for binge eating in bulimia nervosa (BN), empirical knowledge on the influence of emotions on body image in individuals with BN is scarce. The present study sought to experimentally examine effects of a positive and negative emotion induction on body dissatisfaction and selective attention towards negatively valenced body parts among people with BN. METHOD: In a randomized-controlled cross-over design, happiness and sadness were induced by film clips one-week apart in women with BN (n = 23) and non-ED controls (n = 26). After the emotion induction, participants looked at their body in a full-length mirror, while their attentional allocation was recorded with the help of a mobile eye tracker. Participants repeatedly rated their momentary body dissatisfaction. RESULTS: Induction of happiness led to a significant decrease in self-reported body dissatisfaction. Furthermore, attentional bias (higher gaze duration and frequency) towards the most disliked body part relative to the most liked body part was significantly greater in the sadness than happiness condition in BN. No significant effects of emotion induction on gaze duration and gaze frequency during mirror exposure were found for controls. DISCUSSION: In line with assumptions of current models on ED, findings support the notion that emotional state influences the body image of patients with BN.

Prospective associations of negative mood and emotion regulation in the occurrence of binge eating in binge eating disorder.

Retrospective and experimental data demonstrate the importance of emotion regulation (ER) in the maintenance of binge episodes in binge eating disorder (BED). The current study tested whether mood and ER prospectively influence binge episodes in individuals with BED via ecological momentary assessment (EMA). Individuals with BED (n = 79) completed two weeks of EMA. Each sampling point consisted of a series of questions pertaining to participants' mood, ER, and eating behaviour. Successful application of adaptive ER strategies predicted subsequent abstinence, while rumination predicted subsequent binge episodes. However, neither successful application of adaptive ER, nor maladaptive ER, moderated the association between negative mood and probability of binge episodes. This naturalistic study emphasizes the importance of promoting the successful application of adaptive ER skills and cessation of rumination in treatment interventions designed to decrease the occurrence of binge episodes in BED.

Altered Processing of Visual Food Stimuli in Adolescents with Loss of Control Eating.

Loss of control eating (LOC) constitutes a common eating pathology in childhood and adolescence. Models developed for adult patients stress a biased processing of food-related stimuli as an important maintaining factor. To our knowledge, however, no EEG study to date investigated the processing of visual food stimuli in children or adolescents with LOC. Adolescents with at least one self-reported episode of LOC in the last four weeks and a matched control group completed a modified Go/NoGo task, with a numerical target or non-target stimulus being presented on one side of the screen and an irrelevant high-calorie food or neutral stimulus being presented on the opposite side. Mean P3 amplitudes were analyzed. In Go trials, the LOC group's mean P3 amplitudes were comparable irrespective of distractor category, while for NoGo trials, mean P3 amplitudes were significantly higher when the distractor was a high-calorie food stimulus. This pattern was reversed in the control group. Results are interpreted in light of Gray's reinforcement sensitivity theory. They might reflect altered processes of behavioral inhibition in adolescents with LOC upon confrontation with visual food stimuli.

Mirror exposure therapy for body image disturbances and eating disorders: A review.

Mirror exposure therapy is a clinical trial validated treatment component that improves body image and body satisfaction. Mirror exposure therapy has been shown to benefit individuals with high body dissatisfaction and patients with eating disorders (ED) in clinical trials. Mirror exposure is an optional component of cognitive behavioral therapy (CBT), an effective treatment for body dysmorphic disorder (BDD). However, most clinical trials of mirror exposure therapy have been small or uncontrolled and have included few male subjects. Adverse events have been reported during mirror exposure clinical trials. We discuss how individuals respond when looking in a mirror and how mirrors can be used therapeutically, and we critically evaluate the evidence in favor of mirror exposure therapy. We discuss clinical indications and technical considerations for the use of mirror exposure therapy.

Stress-induced body dissatisfaction in women with binge eating disorder.

Stress is known to be a trigger for binge eating in individuals with binge eating disorder (BED). However, the influence of stressful situations on BED patients' body image is less understood. Our study objective was to gain insight into the effects of inducing psychosocial stress on body dissatisfaction in women with BED. Overweight women with BED (n = 29) and without an eating disorder (control group, CG; n = 38) underwent the Trier Social Stress Test for Groups (TSST-G stress) and a nonstressful control task (TSST-G no stress). Additionally, to test for the influence of body salience, participants were either exposed or not exposed to a mirror. Participants repeatedly rated their current body dissatisfaction and psychological distress. Simultaneously, biological stress reactivity was measured using salivary cortisol and alpha-amylase (sAA). Participants responded to TSST-G stress with significantly higher psychological and biological stress compared to the TSST-G control task. The psychological distress response was significantly greater in women with BED than the CG. As hypothesized, exposure to acute socioevaluative stress led to exacerbated body dissatisfaction in the BED group only. The findings of the present study suggest that acute socioevaluative stress may play an influential role in BED patients' body dissatisfaction. Body image programs might benefit from targeting stress management or coping skills in patients with BED. (PsycINFO Database Record

Is It Possible to Enhance Intensity in Guided Imagery Exercises? An Experimental Study.

OBJECTIVE: Guided imagery exercises can have a powerful impact on distressing mental images. Clinically, it is usually recommended to experience these exercises as intensely as possible. However, patients sometimes object to the related instructions. In this study, we tested whether typical clinical instructions aiming at increasing intensity led to a stronger effect of the exercise. METHODS: Sixty-four healthy participants watched a trauma movie clip. Then they were pseudo-randomized into one of two strategies (intense, less intense) or a waiting control condition. Dependent variables were self-reported emotional intensity and psychophysiology measures. RESULTS: Participants in the intense ImRS strategy did not experience the exercise as more intense than those in the less intense ImRS strategy on any outcome measure. Both ImRS strategies showed increased sympathetic activation compared to a decrease of activation in the waiting control group. CONCLUSIONS: Our results suggest that emotional intensity in guided imagery exercises may not depend very much on the therapist's instructions.